VA-BC CERTIFICATION / VA-BC EXAMS / VA-BC
STUDY GUIDE 2024-2025 ACTUAL EXAM 100 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES |ALREADY
GRADED A+
What are the insertion procedures for a PICC? - ANSWER-Antimicrobial catheters for high risk patients,
follow guidelines, Max sterile barrier precautions, Avoid blind stick, avoid catheter tip in upper SVC or
midclavicular, Confirm with ECG or radiograph, check for blood return prior to infusion
What are the supplies for a PICC and what is the Optimal tip location? - ANSWER-PICC device, Sterile
insertion tray, Ultrasound, ECG system, normal saline flush, heparin flush. Caval atrial juncture
What are the Pediatric considerations for a PICC? - ANSWER-Alternative vein selection like scalp and
popliteal vein. Heparin may decrease catheter occlusion.
What are the indications for a Tunneled Catheters? - ANSWER-Infusions for months or years, Apheresis,
What are the contraindications for a Tunneled Catheters? - ANSWER-Current infection, severe
coagulopathy, Cellulitis on insertion site.
What are the vessel selection for a tunneled catheter? - ANSWER-Subclavian, Jugular, and Femoral vein.
What is the insertion procedure for tunneled catheter? - ANSWER-Follow guidelines, sedation, stabilizing
dacron cuff attached to the catheter will be positioned in the tissue track to secure the catheter, exit site
will heal within 2-3 weeks, once cuff has developed tissue attachment and exit site is healed, it may be
maintained without a dressing upon physician approval, confirm with ECG or Xray, obtain free flowing
blood.
What are the supplies for a tunneled catheter? - ANSWER-tunneeled central venous catheter, sterile
insertion tray, ultrasound, surgical equipment, dressing supplies, normal saline, heparin flushes, What is
optimal tip location and pediatric considerations for tunneled catheter? - ANSWER-Cavoatrial junction or
Inferior vena cava.
Catheter tip location (assess as the child grows to maintain in SVC.
,What are the Indications and contraindications for a Implanted venous port? - ANSWER-infusions for
months to years.
Severe coagulopathy, uncontrolled sepsis, burns, cellulitis on site, cachectic, below body weight or
lacking tissue for port implantation.
What are the site selections for implanted venous port? - ANSWER-Peripheral: Basilic or cephalic vein
Central: Subclavian, Jugular, femoral vein.
What are the considerations for implanted venous port access? - ANSWER-comfort for location of port,
depth must be shallow enough to palpate and insert a non-coring access needle safely to maintain
access into the port septum.
What are the insertion procedures for implanted venous port access? - ANSWER-Follow guidelines,
scheduled operative/radiology procedure, sedation, site may be upper chest or lower abdominal side
area depending upon thevein accessed, port is sutured into a subcutaneous pocket under the skin,
different designs shapes and types, confirm with fluoroscopy or radiography, follow policies, obtain free
flowing blood.
What is the optimal tip location for implanted venous port? - ANSWER-Cavoatrial junction, inferior vena
cava above level of diaphragm if inserted into femoral vein.
What are the Indications and contraindications for Intraosseous Devices? - ANSWER-Indications are to
use it as a alternative to venous access in emergency situations. Used often in Peds.
Contraindications is trauma, fracture, or bone disease in access area.
What is the insertion procedures and supplies for the Intraosseous Devices? - ANSWER-Follow
manufactures directions, site disinfection, aseptic technique, IV fluids, blood and meds may be
administered.
Supplies are interosseous access needle device, disinfecting agent, numbing agent, transparent dressing.
What are the indications and contraindications for dialysis or apheresis Catheters? - ANSWERIndications
are hemodialysis, apheresis for plasma or platelets.
Contraindications is that its rarely used for infusion
,What is the site and vessel selection for Dialysis or Apheresis Catheters? - ANSWER-Jugular, Subclavian or
femoral vein.
What is the Insertion procedures and Supplies for Dialysis or Apheresis Catheters? - ANSWER-Follow
manufactures directions, may be scheduled as operative procedure or interventional radiology
procedure, catheter lumen is 13-16 gauge size, catheter ridged for rapid blood flow, avoid blind stink.
Supplies are Dialysis or Apheresis catheter device, sterile insertion tray, ultrasound equipment, surgical
equipment.
What is the Optimal Tip Location for Dialysis or Apheresis Catheters? - ANSWER-Upper right atrium
What are the indications and contraindications for pulmonary artery catheters? - ANSWER-Indications is
assessment of cardiac function specifically to monitor Cardiac output.
Contraindications is mitral stenosis, right heart mass, tricuspid or pulmonary mechanical valves.
What is the site for pulmonary artery catheters? - ANSWER-right subclavian or IJ
What are the indication and contraindications for Aquapheresis Catheters? - ANSWER-Indications is
diuretic resistant CHF and contraindications is lack of accessible basilic vein in upper arm.
What is the Optimal tip location for Aquapheresis Catheters? - ANSWER-1-2 centimeters below the axilla
Describe the things you need to know about Pediatric Umbilical catheters? - ANSWER-The available
vessels include 2 umbilical arteries and 1 umbilical vein. may access up to the 4th day and can use up
until the 14th day.
What are the different types of Skin preparation? - ANSWER-Antiseptic: Chemical agent the inhibits
microorganisms on skin to prevent infection.
Disinfectant: Chemical agent that destroys microorganisms on objects.
Aseptic Technique: Steps designed to reduce and minimize risk of transmission of pathogens to patient.
No touch technique: type of aseptic technique where key areas of items for infusion are not to be
touched prior to insertion.
, Describe what you should know about Chlorhexidine gluconate? - ANSWER-Apply back and fourth for 30
seconds. Effective against gram positive and negative organisms. 48hrs of residual activity. caution with
peds under 2 months of age.
Describe what you should know about Alcohol? - ANSWER-70% concentration and still used in skin
antisepsis. denaturing the cell proteins and dissolving the cell lipids. bactericidal effect on gram positive
and negative bacteria. has good fungicidal and virocidal activity. lacks residual once evaporates.
Describe what you should know about surface disinfectant? - ANSWER-Solution wipe that kill bacteria,
viruses, and fungi on inanimate objects. Used on hard nonporous surfaces and equipmen betweent
patient uses and prior to setting up sterile field.
Describe what you should know about adhesive remover? - ANSWER-Removes sticky residue, dressings,
stitches. decrease skin trauma and tears. do not use on insertion site.
What kind of precautions should you use during CVAD and peripheral midline insertion? - ANSWER-
MSBP (maximal sterile barrier precautions)
What should you know about flushing? - ANSWER-Disinfect the needleless connector, injection port or
catheter hub using friction scrub with isoprophl alcohol or chlorehexidine gluconate prior to access.
Flush with 0.9% preservative free sodium chloride.
Discuss the dressing changes for CVAD's/Midlines/PIV's? - ANSWER-Transparent semipermeable
membrane (TSM) polyurethane dressing is recommended, as it allows for direct visualization and for
release of moisture produced by skin. TSM dressings need to be changed every 7 days, or when wet,
loose, or soiled.
Gauze dressing are used for bleeding and are changed every 2 days, when wet, loose, or soiled.
CVADs/Midlines should use an all inclusive kit or cart, use clean gloves, remove dressing, assess site for
complications, measure external length of catheter compare to length previous recorded, avoid using
organic solvents with CVAD dressing changes, hand hygiene, use Alcoholic chlorhexidine gluconate >0.5%
(caution with infants under 2 months) with 70% isoprophyl alcohol antiseptic,
What should know about removal or replacement? - ANSWER-Replace any device ASAP within 48hrs,
remove if signs of phlebitis, infection, or malfunction. See if culture i needed on infected device. Position
